Perinatal Mood and Anxiety Disorders: Symptoms, Timeline, and FAQs
The spectrum of perinatal mood and anxiety disorders includes everything from postpartum anxiety and depression to postpartum psychosis. We answer the most common questions about these conditions below.
Mood fluctuations in the postpartum period are very common, and to a certain extent, normal. But how do you know if what you’re experiencing is more than just the baby blues? What can you expect if you suspect you have a postpartum mood disorder? What are the symptoms, how long do they last, and are they treatable? All birthing women deserve to know the answers to these questions, so they can be advocates of their health and wellbeing.
We’ve got the answers to your most pressing questions about postpartum mental health and perinatal mood and anxiety disorders (PMADs). Be sure to read our previously published PMADs overview to learn more about the various conditions on the spectrum of postpartum mood disorders. And if you’re experiencing one of these conditions, remember that you’re not alone. Help is only a phone call away: Postpartum Support International offers a helpline for new moms who need support. Call 1-800-944-4773, push #1 for Spanish or #2 English.
What are the symptoms of postpartum depression and other PMADs?
Symptoms can vary based on the type of PMAD you are experiencing, though there is plenty of overlap. For example, someone who is managing postpartum OCD may have more anxious symptoms than someone who is managing postpartum depression.
Here are some common symptoms of postpartum depression:
Depressive mood swings that occur after the first two weeks postpartum, and that don’t resolve on their own
Sadness or a feeling of hopelessness
Trouble sleeping or sleeping too much
Lack of pleasure in activities that would normally make you happy
Difficulty bonding with your baby
Problems with appetite
Crying
Anxious thoughts
Other PMADs such as postpartum anxiety or rage may present with symptoms like:
Obsessive or compulsive thoughts
Fears or worries not based in reality
Angry outbursts
Violent thoughts or behaviors such as slamming doors or punching walls
Unwanted or intrusive thoughts
Hypervigilance
Panic attacks
In extreme cases like postpartum psychosis, delusions or hallucinations
What are the causes of PMADs?
While it’s hard to pinpoint specific causes for mood disorders in the postpartum period, there are several risk factors that increase the likelihood you’ll develop symptoms.
High risk factors include:
History of depression or anxiety
Lack of attachment to baby in pregnancy or postpartum, or negative feelings toward baby
Abuse, past or current
History of bipolar disorder
Being a single parent
Postpartum complications for mom or baby
Birth trauma, emergency C-section, complications in childbirth, hospitalization in pregnancy
Anxiety, depression, and insomnia in pregnancy
History of severe PMS
Elevated risk factors include:
Stressful life events (financial, social, physical, or otherwise)
Marital distress
Intrusive thoughts
Heightened anxiety that lingers and rarely resolves on it’s own
Poor sleep/sleep deprivation
Low maternal confidence/self-efficacy
Lack of social support
Lack of childcare
Weaning
Returning to work
Low risk factors include:
Baby born at low birthweight
Premature birth
Deviation from birth plan (satisfaction with birth experience)
Giving birth at a young age
Lack of exercise in pregnancy
High glucose levels in pregnancy
Breastfeeding challenges (This is interesting because if breastfeeding is going well, it helps prevent postpartum depression. But if it's challenging, the risk for PPD increases a lot)
Poor relationship with mother
Baby blues - characterized by a negative mood that resolves with support, sleep, and positive coping strategies
Lack of exercise in postpartum
When do PMADs start and how long do they last?
Up to 80% of women experience the baby blues in the first two weeks after birth. But if your symptoms persist or begin after the first two weeks postpartum, you may have a PMAD. PMADs can develop any time in the first 12 months after birth.
It’s hard to say how long postpartum depression or other postpartum mental health conditions may last. Everyone is different, and if you seek treatment, you may have a faster recovery than someone who does not. If you do not seek treatment, your symptoms can worsen over time. If you suspect you are struggling with a postpartum mood disorder, contact your medical team, a therapist, or a support group right away.
Are there natural ways to relieve PMADs?
Natural remedies can help alleviate the symptoms of mood disorders like postpartum depression, but often they are not enough on their own to fully treat PMADs.
There is research that indicates diet plays an important role in managing postpartum mood. Omega-3s fatty acids, B vitamins, and amino acids are important for mood regulation, and carbohydrates are also necessary for serotonin production.
Spending time outside, exercise, and meditation can also help alleviate symptoms of PMADs. The best path forward is to consult a doctor and naturopath who are well-versed in postpartum mood disorders to find the best treatment plan for you.
Does exercise help postpartum mood disorders?
The short answer is: yes! Many studies have concluded that exercise can help mitigate symptoms of postpartum depression. And don’t worry if you can’t fathom finding the energy for a high-intensity exercise session — walking alone is enough to boost your mood.
Do PMAD medications interfere with breastfeeding?
In general, antidepressant medications are usually considered safe for breastfeeding mothers when clinically prescribed. That said, some medications are considered better than others. It is critical that breastfeeding women considering medication for PMADs consult with their doctor about the best treatment options available.
The bottom line
While research about PMADs continues to evolve, we understand more about these postpartum mood conditions now than ever. Treatment is often safe and effective, but we must overcome the stigma of maternal mental health so women feel comfortable seeking help.
If you are experiencing symptoms of a postpartum mood condition, reach out to your doctor or the Postpartum Support International hotline. Call 1-800-944-4773, push #1 for Spanish or #2 English.
The more you know, the better equipped you will be to spot the signs of a postpartum mood disorder before it escalates. Help is available and maternal mental health concerns are common. You deserve the help you need to thrive.
Other studies cited: